Disorders of the Gastrointestinal System, 2nd Edition
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mass to resolve itself. If this is not accom- plished, or if there are signs of perforation or peritonitis, the patient must have sur- gery. Hydrostatic reduction is used con- sistently in many healthcare organizations as a diagnostic tool and a treatment. The effectiveness of this technique depends on the patient’s overall condition and/or factors contributing to the intussuscep- tion, the technique and experience of the provider, and the positioning of the in- tussusception. This is the preferred treat- ment method for children and infants, as it generally does not require sedation or anesthesia and can help avoid surgery in pediatric patients (Vo & Sato, 2022). Surgery The surgeon first attempts to manual - ly reduce the intussusception by “milk- ing” or stroking the intussusception back through the bowel. If this fails, or if compli- cations such as strangulation, gangrene, or perforation are present, a resection of the affected portion of the bowel is per- formed. Surgery is the preferred treat- ment method, as most adult occurrences result from malignancy or other gastroin- testinal problems (Brill & Lopez, 2022).
eign bodies found are often food-related objects such as fruit pits, meat boluses, bones, dentures, toothpicks, or intention- ally swallowed nonfood items (Triadafilo - poulos, 2022). In some cases, packets of illegal drugs are ingested to avoid detec- tion, and they can leak or open inside the body and cause overdose or poisoning (Munter, 2018). In addition to swallowed foreign bod- ies, rectally inserted foreign bodies are a concern. In many cases, treatment is delayed, and patients may be unwilling to discuss why a foreign body is pres- ent, making additional treatment needs difficult to discern. Unfortunately, rectal foreign bodies carry a high risk of perfo- ration and intestinal damage, given the wide variety of items that can be inserted and subsequently broken or lost inside the colon (Bhasin & Williams, 2021). For - eign bodies are passed without incident in about 80% of cases, especially after they reach the stomach. However, per- foration, obstruction, or intestinal injury can occur in some cases, especially in children (Triadafilopoulos, 2022). Imaging is usually necessary to confirm a foreign body is present and to assess its location, risk of internal injury or obstruction, and need for potential surgical intervention. Typically, x-rays are adequate for identifi - cation, but in some cases, an endoscopy may be necessary to visualize the foreign body or assist with removal, especially if it is suspected to be in the oropharynx (Tri- adafilopoulos, 2022).
Foreign bodies in the gastrointestinal tract
Foreign bodies are often accidentally swallowed but may be intentionally swal- lowed in cases like drug smuggling. Most cases (up to 85%) involve children, but psychiatric patients, prisoners, and those without teeth are the most common adult presentations (Munter, 2018). Children often put things in their mouths. Coins, small toys, and pieces of broken toys are frequently ingested. Magnets are espe - cially dangerous, and if multiple magnets are ingested, they can stick to one anoth- er and cause pressure-related injury and pulling of the GI tract. In adults, the for-
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